Managing the femoral artery in coronary angiography.

Vascular access and subsequent methods to obtain haemostasis are commonly overlooked components of coronary angiography, yet most complications related to diagnostic coronary angiography and percutaneous coronary interventions come from groin bleeds. Most of these complications are minor, leading to bruising and patient discomfort. However, major vascular complications such as retroperitoneal bleeding are life threatening. A number of devices are now available to ensure the arteriotomy can be closed immediately at the end of the procedure. These devices have advantages but are in themselves the source of additional complications, which are not seen without them. The mechanisms related to the use of these devices and the potential complications that they may cause should be understood by all cardiologists performing coronary angiography.